ABPNS

Credentialing for Physician Nutrition Specialist

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Definition of Physician Nutrition Specialist® (PNS)

 A Physician Nutrition Specialist® (PNS) is a physician with training in nutrition who devotes a substantial career effort to nutrition and who can assume a leadership role in coordinating interdisciplinary clinical nutrition services and education in academic health centers, other medical centers, private practice, and other health care settings. PNSs generally have backgrounds in the specialties of internal medicine, pediatrics, family medicine, or general surgery, and sometimes in subspecialties such as adult or pediatric gastroenterology, endocrinology, critical care, nephrology, cardiology, or others. They have completed a period of defined nutrition training, in addition to categorical residency training, that includes mastery of a defined core of knowledge and completion of a period of mentored clinical nutrition experience, which may be obtained in a nutrition fellowship or as part of training in another subspecialty. They have satisfied all requirements of, and are certified by, the American Board of Physician Nutrition Specialists.

Training Standards for Pysician Nutrition Specialist® (PNS) / Eligilbiity for Physician Nutrition Specialist® (PNS) Training

  1. All candidates for certification and recertification must be licensed to practice medicine in the country in which they reside (note that ABPNS certification is not creditable toward licensure to practice medicine in the United States).
  2. They must be certified by a member board of the American Board of Medical Specialties or the equivalent in other countries.
  3. Completion of at least 6 months (1000 hours) of mentored clinical nutrition experience and formal instruction in inpatient and outpatient settings must also be documented. This may be obtained in a fellowship in clinical nutrition or as part of training in a related subspecialty such as adult or pediatric gastroenterology, endocrinology, critical care, nephrology, cardiology, or others.

ABPNS EXAMINATION CONTENT OUTLINE

 

I.           GENERAL ASPECTS OF NUTRITION

A.     Nutrition through the Life Cycle

1.      Infancy and Childhood

2.      Adolescence

3.      Pregnancy and Lactation

4.      Aging

5.      Gender Differences

B.     Physiology and Pathophysiology

1.      Biochemical Composition of the Human Body

2.      Energy Metabolism

3.      Starvation

4.      The Hypermetabolic/Hypercatabolic State

5.      Cytokines and Eicosanoids

6.      Gastrointestinal Tract

C.     Complementary and Alternative Therapies

1.      Nutraceuticals

2.      Dietary Supplements

3.      Functional Foods

4.      Vegetarian Diets

5.      Elimination Diets

D.     Public Health

E.      Cultural, Ethnic, and Ethical Issues

F.      Technology

1.      Food Composition and Technology

2.      Genomics and Proteomics

II.        NUTRIENTS AND INTEGRATIVE NUTRITION

A.     Protein

1.      Dietary

2.      Essential Amino Acids

3.      Nonessential Amino Acids

B.     Carbohydrates

1.      Complex

2.      Disaccharides

3.      Glucose

4.      Others

C.     Fiber

1.      Properties of Dietary Fiber

2.      Water Soluble

3.      Water Insoluble

D.     Fats and Oils

1.      Omega 3 Fats  

2.      Monounsaturated Fats

3.      Cholesterol

4.      Others 

E.      Fat Soluble Vitamins

1.      Vitamin A

2.      Vitamin D

3.      Vitamin E

4.      Vitamin K

F.      Water Soluble Vitamins

1.      Thiamin

2.      Folic Acid

3.      B12

4.      Vitamin C

5.      Others

G.     Electrolytes, Minerals and Water

1.      Sodium

2.      Potassium

3.      Calcium

4.      Magnesium

5.      Phosphorus

6.      Iron

7.      Water

8.      Others 

H.     Trace Elements and Ultra-Trace Elements

1.      Zinc

2.      Copper

3.      Selenium

4.      Others

III.      NUTRITIONAL STATUS ASSESSMENT

A.     History and Physical

1.      Medical History

2.      Diet History and Counseling

3.      Physical Exam and Anthropometry

B.     Laboratory Data

C.     Body Composition

D.     Nutrient Deficiencies and Excesses

E.      Energy and Protein Requirements

1.      Energy Expenditure

2.      Protein-Energy Malnutrition

3.      Altered Requirements in Disease States

IV.     OBESITY

A.     The Obesity Epidemic: Changes in the Environment

1.      Physical Activity

2.      Food Supply

3.      Psycho-social Environment

4.      Controversial Factors

a.       Infection Theory

b.      Other Environmental Agents

B.     Regulation of Energy Balance

1.      Appetite Regulation

2.      Adaptation to Starvation

3.      Energy expenditure

4.      Neuro-endocrine Regulation of Energy Balance

C.     Changes in Body Composition in Overnutrition

D.     Eating Disorders

1.      Binge-Eating Disorder

2.      Night Eating Syndrome

3.      Compulsive Overeating

4.      Anorexia Nervosa

5.      Bulimia Nervosa

6.      Other Eating Disorders

E.      Secondary Obesity

1.      Obesity Genetics

2.      Endocrine Factors

3.      Neurological Causes

4.      Pharmacologic Causes

F.      Pediatric Obesity

G.     Co-morbidities of Obesity

H.     Nonsurgical Interventions

1.      Caloric Restriction

2.      Physical Activity, Exercise, Fitness

3.      Cognitive and Behavior Therapy

4.      Popular Weight Control Programs

5.      Multidisciplinary Team Management

6.      Pharmacotherapy of Obesity

7.      Iatrogenic Complications

8.      Other

I.        Bariatric Surgery (Nonoperative Management)

1.      Selection and Screening

2.      Bariatric Procedures

3.      Preoperative Evaluation and Management

4.      Perioperative Monitoring and Management

5.      Long Term Monitoring and Management

V.        DISEASE-SPECIFIC NUTRITION

A.     Gastrointestinal Disorders

1.      Intestinal Failure

2.      Pancreatitis, Acute and Chronic

3.      Inflammatory Bowel Disease

4.      Irritable Bowel Syndrome

5.      Disorders of Gastrointestinal Motility and Flora

6.      Celiac

7.      Short Bowel Syndrome

8.      Other

B.     Hepatobiliary Disorders

1.      Cholestasis

2.      Cholelithiasis

3.      Hepatic Failure

4.      Other

C.     Critical Illness

D.     Infection and Sepsis

E.      Blood Lipids and Lipoprotein Disorders

F.      Endocrine Conditions

1.      Type I Diabetes

2.      Type II Diabetes

3.      Metabolic Syndrome

4.      Secondary Hyperparathyroidism

5.      Polycystic Ovaries and other Ob/Gyn Disorders

6.      Other

G.     Renal Pathophysiology and Disorders

H.     Cardiovascular Disorders

1.      Hypertension

2.      Atherosclerosis

3.      Cardiac Cachexia

4.      Other

I.        Pulmonary Disorders and Respiratory Function

1.      Sleep Apnea

2.      Pulmonary Cachexia

3.      Other

J.       Bone Pathophysiology and Disorders

1.      Metabolic Bones Disease and Osteoporosis

2.      Osteoarthritis

3.      Dental

4.      Other

K.     Cancer

L.      Anemia and other Hematologic Diseases

M.    Nervous System Disorders

N.     Surgery and Trauma

O.     Genetic and Pediatric Disorders

P.      Transplantation

Q.     Adverse Effects of Ethanol

R.     Psychiatric Disorders

VI.     ENTERAL AND PARENTERAL NUTRITIONAL SUPPORT

A.     Relative Merits of Enteral and Parenteral Nutrition

B.     Indications and Contraindications

C.     Management of Enteral and Parenteral Nutrition

1.      Routes

2.      Nutrient Composition and Glycemic Control

3.      Initiation and Refeeding Syndrome

4.      Transitional Feedings, Weaning and Discontinuation

5.      Monitoring Nutritional Support

D.     Home Enteral and Parenteral Nutrition

E.      Short Bowel Syndrome

F.      Complications of Nutritional Support

1.      Mechanical

2.      Physiological

3.      Metabolic

4.      Septic

5.      Drug-Nutrient Interactions

G.     Pediatric Nutritional Support

 

 

ABPNS Curriculum Guide

  1. General Aspects of Nutrition
  2. Nutrients and Integrative Nutrition
  3. Nutritional Status Assessment
  4. Obesity
  5. Disease-Specific Nutrition
  6. Enteral and Parenteral Nutritional Support
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